Psychomotor+ stimulants 21-22 Flashcards
Amphetamines/ mainly methamphetamines and Cocaine prefice
Just know that they work similarly to have similar effects on CNS, PNS and abuse.
Only diff is that Coke inhibits synaptic reuptake of Dopamine and NE
while meth/amphets increase release of but both = same effect
Amphetamine (adderall)
(he didn’t say much bout this)
L isomer of amphetamine or asymmetric carbon containing isomer
- can function as a broncho dilator and has more peripheral effects
( he didn’t have this on slide he just said this)
D-amphetamine (adderall)
D isomer* of amphetamine and *has a greater effect on CNS
Lisdexamfetamine (Vyvanse)
- Prodrug with Lysine residue attached to it which needs to cleaved by the liver, this is the rate limiting step. This limiting step suppsoedly limits abuse potential and taking higher doses will not produce a high
- ## can give you confidence, focus and makes you more outgoing
Methamphetamine
aka: Speed, crank or ICE
and Desoxyn
-the METH in methamphetamine refers to an extra Methyl group making the drug resistant to MAO metabolism. This is increases its lipid solubility allowing for BBB passage. Meth also has longer action compared to regular amphetamines and adderall
- ICE is the smokeable crystal version similar to crack (rocks)
- Desoxyn is a methamphetamine version of Adderall but no one uses it
Methylphenidate
- primary site of action is locust ceruleus which contains the most NE producing Neurons in brain
- The primary target for these adhd drugs is actually NE release but Dopamine release is also targeted for reward center activation (Nucleus ACCUMBANS)
- allows child to focus attention
Cathinone (KAT/QAT)
- found in/ produced by khat plant and is a meth-like/amphetamine like drug which produced stimulant effects
- used by Yemenis and Somalis and specifically in Somalian militants
- it was previously sold as “BATH SALTs” in headshots in US
Ephedrine/Psuedophedrine
- Natural product found in herbal preparation (MaHuang;Chinese shit)
- **In the 90s was used among athletes as a pre workout however sharp increases in BP/HR would lead to death by HF so it was banned
Modafanil and Armodafanil
(Joe rogan loves modafanil )
- Similar to amphetamines but are technically not although they do same shit
- Approved for narcolepsy and shift work disorder
(basically you just work multiple jobs on a shitty schedule so u don’t sleeP)
METHAMPHETAMINE uses/effects and AE
-Everything on here is important
-
Increases wakefulness/arousal affecting CNS: increase of NE release to LOCUS CERULEUS
-weightloss but not good cuz u gain it back after stopping: VIA HYPOTHALAMIC stim
** was used in WW2 among soldiers
* FORMICATION tactile hallucinations (bugs crawling underskin)
** Psychosis - can cause paranoia/ schizophrenic like symptoms which is important to rule out when diagnosing someone who may use drugs. IT IS REVERSIBLE
** Mydriasis
** SKIN LESIONS - “Formication” makes users violently scratch skin and the combination of NE SNS vasoconstriction leads poor healing ability
** METHMOUTH/ DENTAL - smoking meth ruins teeth and NE SNS combo also restricts proper blood flow
*** Potential for IRREVERSIBLE dopaminergic and Sertonergic path damage leading to development of Parkinson - CNS rebound cycle - coming of drug makes you feel like shit causes a cycle to go back to drug
Coke/ COCA plant
(he talked about this shit for a min and considering its prozialack im assuming he gonna ask about this)
- aside from its use in Coke (the soda) it was used by Inca Indians bc of its ability to suppress appetite and alleviation of altitude sickness bc they lived high in the mounts
- they chewed leaves
Cocaine HCL
Powdered white people coke
-Water soluble
- snorting or IV are more common
- oral ingestion is another route but not a good method to get high bc of HEPATIC 1st Pass
Cocaine Free Base
(Hellcat driver/ basketball people drug)
CRACK
- fat soluble and the rocks are smoked
- they mix that hoe with NACL to neutralize HCL
Cocaethylene
This is a predicate or byproduct caused by mixing alcohol and Coke which is found to be related to CARDIOMYOPATHY and other CV effects
Generalized Coke AE/contraindications
** pregnant one important
- stim CNS: Euphoria, well being, appetite suppression,
- Stim SNS: increases HR BP -> arrhythmias, stroke, sudden death
- * IN PREGNANCY mothers who use coke results in brith defects because of vasoconstriction of placental blood flow**
- Withdrawal -> lethargy, Anhedonia, irritability/hostility
- Excessive stim can also cause paranoia, hallucinations and Psychosis
